The Biden administration has announced a new federal rule aimed at bolstering civil rights protections for transgender and other LGBTQ individuals. This rule, announced by the Department of Health and Human Services (HHS), reverses a Trump-era regulation that had rolled back discrimination protections based on gender identity and sexual orientation under Section 1557 of the Affordable Care Act (ACA).
Section 1557 prohibits discrimination on the basis of various factors by entities that primarily provide health care and receive federal funding. This includes discrimination based on race, color, national origin, sex, age, or disability. The rule is enforced by the HHS Office for Civil Rights.
HHS Secretary Xavier Becerra stated that the new rule provides Americans with a clear way to address discrimination when seeking healthcare services or engaging with health programs overseen by HHS. The new rule comes at a time when over 20 states have imposed restrictions on or banned gender-affirming care for children. In addition, more than a dozen states are currently facing lawsuits over their policies regarding youth gender affirming care. The rule aligns with the US Supreme Court’s 2020 decision in Bostock v. Clayton County, which determined that LGBTQ individuals are protected from discrimination under Title VII of the Civil Rights Act of 1964.
In response to the Bostock decision, the Biden administration announced in 2021 that it would interpret the word “sex” in the ACA to include gender identity. The new rule will be enforced for health insurance plans operating through Medicare, Medicaid, or the Obamacare exchanges, including care provided under Medicare Part B, such as services offered in a doctor’s office. This includes coverage for gender-affirming services for children and young adults who are seeking medical treatment related to their gender identity.
